Changes in lipid profile of obese patients undergoing sleeve gastrectomy with Transit Bipartition surgery.

The aim of this study was to investigate the short- and long-term changes in lipid profile caused by Sleeve Gastrectomy with Transit Bipartition Surgery (SG+TBS), which is one of the current metabolic surgery techniques. The study included patients who underwent SG+TBS between June 2015 and May 2019. The analyzed data included patients' demographic datas, obesity classification (Overweight, Class 1, 2, 3), and cardiovascular risk groups. Total Cholesterol (TC), triglycerides, Low-Density-Lipoprotein-Cholesterol (LDL-C), High-Density-Lipoprotein-cholesterol (HDLC) serum concentrations of patients were measured at the time of admission to the outpatient clinic and at 3 and 12 months postoperatively. The study population consisted of a total of 499 patients, 263 males and 236 females, with a mean BMI of 34.86 ± 4.90 kg/m2 and a mean age of 53.84 ± 8.93 years, who underwent SG+TBS. There was a significant decrease in the 3-month and 12-month TC levels, in the 12-month triglyceride levels of all classification groups, compared to the baseline value (p<0.001), There was also a significant decrease in the 3-month and 12-month LDL-C levels of overweight, class 1 and 2 obese patients compared to the baseline values. Although the change in the 3-month value of class 3 obese patients was insignificant, there was a significant decrease in the 12-month value, as in other obesity classification groups (p<0.05) and a significant increase in the 12-month HDL-C values for all classification groups compared to both baseline and 3-month values (p<0.05). There were significant improvements in serum lipid profiles on SG+TBS patients, which are thought to be important in reducing the risks of cardiovascular disease. KEY WORDS: Lipid profile, Obesity, Sleeve gastrectomy with Transit Bipartition.

The Effect of Defense Mechanisms and Eating Awareness on the Probability of Suicide After Bariatric Surgery. / Bariatrik Cerrahi Sonrasi Intihar Olasiligi Üzerine Savunma Mekanizmalari ve Yeme Farkindaliginin Etkisi.

OBJECTIVE: This study aims to investigate the relationship between suicide possibilities, defense mechanisms, and eating awareness of patients who have undergone bariatric surgery. METHOD: The study sample consisted of 101 patients who had bariatric surgery in a private hospital. People who had at least six months from the date of surgery, who had no pregnancy, and who did not give birth after surgery were included in the study. The Mindful Eating Questionnaire, Suicide Probability Scale, and the Defense Style Questionnaire were applied to the participants. RESULTS: While the average age of the sample was 52.46±9.72, 54.5% (n=55) were male. Within one year after the operation, 33.7% of (n=34) patients had lost weight between 21-30 kg, while 21.8% (n=22) had lost weight between 11-20 kg. Suicide probability scale scores are predicted by emotional eating (ß=0.272, p=0.004), neurotic defense mechanism (ß=0.284, p=0.003) and current body mass index (ß=0.258, p=0.008). CONCLUSION: The possibility of suicide after bariatric surgery is closely related to emotional eating, neurotic defense mechanisms, and body mass index. The solution to the problem of emotional eating rather than decreasing the body mass index may be more effective in decreasing the suicide possibilities of the patients. Therefore, in patients undergoing bariatric surgery, emotional eating is one of the problems that should be handled both before and after surgery.

Comparison of preoperative and postoperative Lipid Profile changes in obese and morbidly obese patients after mini gastric bypass surgery.

BACKGROUND & OBJECTIVE: Obesity has become a serious health problem that has become increasingly important in recent years. Since patients with high levels of obesity have dyslipidemia and an unbalanced lipid profile, they have a high risk of both diabetes mellitus and cardiovascular disease. This study aimed to evaluate the short (3 months) and long term (12 months) effects of mini-gastric bypass surgery from the current bariatric surgical techniques on the lipid profile. METHODS: Of the patients undergoing Mini-gastric bypass operation between January 2016 to December 2018 at the General Surgery Clinic of Private Samsun Büyük Anadolu Hospital, demographic data and changes in lipid concentrations at 3 and 12 months were analyzed. Patients were grouped according to age, sex, body mass index (BMI), cardiologic risk groups, bypass lengths, and obesity classes. Total cholesterol, triglyceride, LDL-cholesterol, and HDL cholesterol values of the patients were examined at the time of admission to the outpatient clinic before the operation, at the postoperative third month and at the post-operative twelfth-month. Patients who did not go for a checkup during the one-year follow-up and whose data could not be reached or missing were excluded from the study. RESULTS: There was no significant difference in terms of age, sex, and cardiovascular risk (p> 0.05). Although the HDL-C level was initially low (p <0.001), it significantly increased 12 months after surgical treatment (p <0.001). While serum concentrations of LDL cholesterol, total cholesterol, and triglycerides were high preoperatively, they significantly decreased at 12 months postoperatively (p <0.001). When compared with values in the 3rd- and 12th-month, there was a significant decrease in the class-3 obesity group but not in the class-2 obesity group. When serum HDL cholesterol concentrations were compared with preoperative baseline and postoperative 12th-month those, no statistically-significant difference was found in serum concentrations in the 3rd month, although there was a significant increase in both class 2 and 3 obesity groups. CONCLUSION: In patients undergoing mini-gastric bypass surgery, serum LDL cholesterol, total cholesterol, and triglyceride concentrations decreased in the 12th postoperative month, but serum HDL cholesterol concentrations increased.

Cancers Detected During the Evaluation Before Bariatric Surgery in Obese Patients: a High-Risk Population for Cancers and Their Prevalence.

PURPOSE: The purpose of the present study was to determine the types and prevalence of cancers in obese patients who have risks for cancer with multidisciplinary evaluation in managing the patients before bariatric surgery. MATERIALS AND METHODS: The study had a descriptive cross-sectional method conducted by examining patients' files retrospectively. The frequency and types of diseases with cancer during the multidisciplinary evaluation of the study group with a BMI ≥ 40 kg/m2 before bariatric surgery were used as the study data. RESULTS: A total of 1354 (64.97%) of these patients underwent bariatric surgery (for obesity), and 730 (35.02%) cases underwent metabolic surgery (type 2 diabetic patients). Eighteen patients had thyroid papillary cancer (0.86%) and colon cancer was detected in 8 people (0.38%), breast cancer in 6 people (0.47%), stomach cancer in 5 people (0.23%), kidney cancer in 3 people (0.1%) 4), lung cancer in 2 people (0.09%), pancreatic cancer in 2 people (0.09%), adrenal cancer in 2 people (0.09%), and neuroendocrine tumor in 1 person (0.04%). CONCLUSION: It was found that obesity and some cancers are related. Weight loss to be achieved with obesity surgery can reduce the risk of obesity-related cancers.

Prospective randomized comparison of single-incision laparoscopic cholecystectomy with new facilitating maneuver vs. conventional four-port laparoscopic cholecystectomy.

OBJECTIVE: We aimed to investigate the technical feasibility of single-incision laparoscopic cholecystectomy (SILC) with our new facilitative maneuver and to compare it with the gold standard four-port laparoscopic cholecystectomy (LC). MATERIAL AND METHODS: Operation time, cosmetic score and incisional hernia rates between LC (n=20) and SILC-1 (first 20 consecutive operations with the new technique) and 2 (subsequent 20 operations with the new technique) were compared. RESULTS: The median operation time for LC, SILC-1 and SILC-2 were; 35 min (12-75), 47.5 min (30-70), and 30 min (12-80), respectively (p=0.005). The operation duration was similar in LC and SILC-2 (p=0.277) groups. Wound seroma rate was higher in SILC-1 (45%) and SILC-2 (30%) groups than LC (5%) group (p=0.010). Cosmetic score was similar between all the groups. Hernia rates were 15.8% and 5.3% in the SILC-1 and SILC-2 groups, respectively, while there was no hernia in the LC group. CONCLUSION: SILC with new facilitating maneuver is comparable with classical four-port laparoscopic cholecystectomy in terms of ease, operation time, reproducibility and safety. Besides these advantages, the single-incision access technique must be optimized to provide comparable wound complication and postoperative hernia rates before being recommended to patients.

Intestinal malrotation in an adult: case report.

Intestinal malrotation is a developmental anomaly of the midgut in which the normal fetal rotation of intestines around the superior mesenteric artery and their fixation in the peritoneal cavity fail. Rotational anomalies of the midgut are rare in adults. Operative intervention is required generally when they are symptomatic. While difficult to diagnose, prompt recognition and surgical treatment usually lead to a successful outcome. Intestinal malrotation is rarely asymptomatic and generally diagnosed incidentally in adults. In the present report, a case of incidental intestinal malrotation with clinical findings of small bowel obstruction is discussed with a literature review.